Optimism around vaccinations — with steady dose of reality

At University Hospital, CEO Elnahal sees firsthand the far-reaching impact of COVID-19

It’s the overcrowded-hospital, don’t-have-enough-beds, don’t-have-enough-personnel story that people are not hearing about with COVID-19 cases soaring everywhere.

But the behavioral health fallout from the pandemic is just as serious. That’s the way Shereef Elnahal, CEO of University Hospital in Newark, explains it.

Last weekend — ironically, at a time when University had a manageable number of COVID-19 cases — it found itself overrun with patients who needed behavioral care.

“We have had nights recently where it has been difficult to staff to unique needs of patients and behavioral health needs,” he said. “That includes nurses, but it also includes observers and security in case there is escalation.”

Which University Hospital had to struggle to find, Elnahal said.

“We’re not a psychiatric hospital,” he said. “We do have a psych unit, but we’re not an entire hospital devoted to that. So, at times, it is difficult to find the staff, especially in the context of the pandemic.”

And, while the number of behavioral health patients University — and other health care facilities across the state — will fluctuate, the issue of care, Elnahal said, is not going away.

“It’s getting worse, especially now with opioid use disorder — numbers are skyrocketing,” he said. “So, we’re going to be dealing with the sequelae from this for a long time, especially in the community we serve.”

Of course, everyone involved in health care right now starts with vaccinating the population. Elnahal agrees it’s the top priority — and he feels University Hospital overall and Newark in general have been handling the situation well. For that, he gives a lot of credit to County Executive Joe DiVincenzo and Mayor Ras Baraka.

“We’ve had a really great rollout of that, and I think we’re on the more efficient side of New Jersey counties in terms of administrations,” he said. “But a lot goes to ‘Joe D,’ who set up five mass vaccination sites himself. He jumped on this from Day One. And Mayor Baraka has also set up multiple sites in the city for vulnerable patients. I think the results are pretty clear.”

It’s a reason for optimism, Elnahal said. As is this: The increase in testing is paying off, too.

“I do think the state really did well in expanding testing and picking up a lot more asymptomatic people,” he said. “So, almost 50% of the positives coming in are now asymptomatic, which is huge. It used to be much less.”

Those people, Elnahal said, are then doing a good job of making sure those around them get tested.

“In the community we serve, I think, when folks find out they have a close friend or a household member who is positive, then, pretty much everyone in the household is getting tested. People have learned to do that, which is really helping.”

Now, it’s moving forward.

Elnahal said there is reason to believe President Joe Biden’s desire to vaccinate 1 million people a day is doable — and soon.

“In general, I’m optimistic about the Biden plan for vaccination,’ he said. “On Friday, we hit a milestone of 750,000 vaccinations throughout the country, so I think will surpass a million, hopefully in a couple of weeks. I know he’s really trying to slow walk it, in terms of expectations, but we’re definitely primed to exceed that goal.”

Elnahal, however, quickly slow-walked how difficult doing that will be. It’s more than just getting more vials of the vaccine, he said.

“It’s more complicated than that,” he said. “Because we have to make sure that we’re not too restrictive with the prioritization — and that we give it to institutions that are better primed and more able to deliver it. For example, Joe D’s vaccination sites: We have worked with each other and are learning from each other.

“You really have to select the right sites to do it. And I think that’s been an issue, because some hospitals in the country just didn’t find enough people in those initial priority categories to vaccinate. And you saw some vaccine go to waste, which is really shame. That should never happen.”

Of course, all this goes back to the opening point: staffing.

Elnahal said he’s worried about the fatigue the health care community is facing — and the challenges it brings.

“There’s a constant cycle of resiliency and building strength in the workforce,” he said. “We need to let people know that it’s OK to identify themselves as someone who’s burned out. We have resources for them. We have the ability to provide counseling, but we also have other options, like peer-to-peer support.

“It’s a big problem. We’ve seen our staff call out more as the months have gone on, because people are fatigued from going nonstop since this pandemic started. What we need is just to accelerate vaccination; that’s our only hope getting out of this.”